A minimally invasive approach for a compromised treatment plan.

A primary goal in dentistry is the execution of appropriate treatment plans that are minimally invasive and maintainable. However, it is sometimes necessary to repair existing dental restorations or revise treatment plans to accommodate changes in a patient's condition. In the present case, a patient who was satisfied with a removable partial overdenture lost a critical abutment tooth. A creative, minimally invasive approach enabled the patient to keep his existing partial prosthesis and avoid the need for a full reconstruction or complete denture.

Reparación intraoral de una prótesis parcial fija metal-cerámica de seis unidades con resina compuesta: relato del caso / Repair of a six-unit fixed partial denture metal-ceramics with composite resin: case report

Múltiples son los factores que pueden desencadenar fracturas de porcelana en una prótesis parcial fija metal-cerámica, aunque esta situación no siempre determina un reemplazo. La reparación de porcelana mediante el uso de resina compuesta es una alternativa con ventajas de una fácil manipulación y bajo costo. El objetivo del presente artículo es presentar a la resina compuesta como una opción con resultados considerables en la reparación de prótesis metal-cerámicas fracturadas, con alto compromiso estético. Se presenta un caso clínico de reparación intraoral de una prótesis fija metal-cerámica de seis unidades en el sector anterior superior. El tratamiento realizado incluyó fresado de la superficie de porcelana, aislamiento absoluto, grabado ácido con fluoruro de fosfato acidulado, microarenado con óxido de aluminio, silanización, aplicación del adhesivo convencional y tres tipos de resinas compuestas, resina opaca, microhíbrida y resina de nanorelleno. A los 8 meses se evaluó la adaptación de la reparación mediante un explorador e inspección visual, secando con una jeringa triple donde no se observó signos de percolación alguna. Basado en los resultados se puede considerar a esta combinación de resinas compuestas como una alternativa útil en la reparación de porcelana fracturada.

There are multiple factors that can trigger a fracture of porcelain in a metal-ceramic fixed partial denture, although a replacement is not always required. The porcelain repair using composite resin is an alternative with advantages such as easy handling and low cost. The aim of this paper is to present the composite as an option with significant results in the repair of fractured metal-ceramic prostheses, with a high aesthetic commitment. We report a case of intraoral repair of a six-unit metal-ceramic fixed prosthesis in the anterior superior sector. The treatment provided included milling of the surface of porcelain, absolute isolation, acid etching with acidulated phosphate fluoride, aluminium oxide sandblasting, silanization, conventional adhesive application and three types of composite resins: opaque resin, micro-hybrid resin and nanofilled resin. After 8 months we assessed the adaptation of the repair using a surface explorer and visual inspection, drying with a triple syringe. No signs of seepage were observed. Based on the results, this combination of composite resins can be considered as a useful alternative in the repair of broken porcelain.

Wear and repair of stainless steel crowns.

AIM: The purpose of this study was to determine the wear of stainless steel crowns (SSCs) in children, and compare the extent of microleakage in SSCs that had been repaired using either a cermet glass-ionomer cement (GIC) or a packable composite resin (CR). MATERIALS AND METHODS: For the first aim, the occlusal surface thickness of 31 harvested SSCs (21 primary first and 10 second molars) and 18 unused SSCs was measured, and then examined under scanning electron microscopy. For the second aim, standardised holes were prepared on the occlusal surfaces of 20 SSCs, and then repaired using either a cermet GIC or packable CR. After their repair, the extent of microleakage was determined using 0.5% basic fuchsin and stereomicroscopy. RESULTS: The thickness of all the harvested SCCs was 5.3 µm less than that of the unused SCCs (p<0.02), and there were no significant differences between the thickness and occlusal wear rates of harvested SSCs from the first and second primary molars. Although neither of the two repair materials completely prevented microleakage, the number of specimens in which microleakage occurred after repair with a cermet GIC was significantly lower than the number of specimens in which a packable CR was used (p<0.05). CONCLUSION: We concluded that the occlusal surfaces of SSCs for first and second primary molars display wear. Although perforated SSCs can be repaired using either a cermet GIC or a packable CR, less microleakage occurs in SSCs that were repaired with a cermet GIC than those with a packable CR.

Reparación intraoral de restauración cerámica: reporte de caso / Intraoral repair of fractured ceramic restorations: a case report

Las cerámicas dentales han logrado en estos tiempos imitar de manera excelente las propiedades ópticas y colorimétricas que tiene la dentición natural, y hoy por hoy en sus características y manipulación se concentran los intentos por lograr la perfección de la estética dental indirecta. Lamentablemente, estas no están exentas de riesgo a sufrir un accidente que las dañe o fracture,sobre todo si son en el sector anterior y, si no es posible hacer el recambio de la pieza protésica por alguna razón, se requeriría una solución urgente y necesariamente lo más compatible con la estética lograda, inclusive en aquella trabajada con subestructurasde metal.

Dental ceramics have achieved great way to mimic the optical and colorimetric properties having natural teeth, and today in its handling characteristics and focus efforts to achieve the perfection of the cosmetic dentistry indirectly. Unfortunately, these are not without risk to suffer an accident that damaged or fracture, especially if they are in the front and if you can not make the prosthetic replacement part for any reason, would require an urgent solution necessarily most compatible with the aesthetics accomplished, including those working with metalic substructures.

[Esthetic repair of crown margins with composite. A case report]. / Asthetische Kronenrandkorrektur mit Komposit. Ein Fallbericht.

Gingival recessions can cause severe aesthetical problems, especially when associated with the exposure of the margin of crown or bridge restorations. When complete root coverage can not be achieved by periodontal surgery techniques, prosthetic restorations are usually replaced to improve the aesthetic situation. This clinical report describes the application of a composite repair filling as an alternative technique to correct the restoration margin and cover the exposed root surface. From the published literature it is known that metallic and ceramic surfaces can be repaired adhesively using composite materials. This procedure is less costly and invasive, but provides satisfactorily aesthetic results.

O uso de microondas para polimerização de prótese total implanto-suportada submetida à carga imediata / Use of microwave for polymerization of implant-supported total prostheses submitted to the immediate load

O presente trabalho demonstra a utilização do forno de microondas para polimerização de prótese total implanto-suportada submetida à carga imediata, reduzindo o período entre a instalação dos implantes e da prótese, com resultados bastante satisfatórios e maior comodidade para o paciente.

Evaluation of shear bond strength of composite to porcelain according to surface treatment

This study evaluated the shear bond strength of porcelain/composite using 40 metal + porcelain + composite cylindrical specimens divided into 4 groups, according to porcelain surface treatment: 1) no treatment, 2) mechanical retentions performed with diamond burs, 3) etching with phosphoric acid+silane, and 4) etching with hydrofluoric acid+silane. After being stored in distilled water at room temperature for one week, the specimens were submitted to a shear force (load) and the data were analyzed statistically (ANOVA). The means (in Mpa) of the groups were: 4.71 (group 1); 4.81 (group 2); 11.76 (group 3); 11.07 (group 4). There were no statistically significant differences between groups 1 and 2 and between groups 3 and 4

The use of resin cements in restorative dentistry to overcome retention problems.

The use of resin cements in combination with dentin bonding agents can result in superior attachment of prostheses to tooth structure. This paper describes four clinical cases in which dentin-bonded resin cements were used to overcome retention problems. In the first case, a detached fixed partial denture, which was in good condition when separated, was recemented to abutment teeth prepared with less-than-ideal angle of convergence. In the second case, a detached all-porcelain crown was recemented with a dentin-bonded resin cement after appropriate surface treatment. In the third case, a porcelain-fused-to-metal crown made for a molar tooth was cemented to a short clinical crown, avoiding crown-lengthening surgery. In the fourth case, a 3-unit fixed partial denture was recemented to abutments with less-than-ideal supporting features. Dentin-bonded resin cements can help to extend the life of detached prostheses until the patient is financially prepared for replacement or it can help to avoid crown-lengthening surgery.

Prótese total maxilomandibular em pacientes submetidos à mandibulectomia segmentar / The total prothesis maxillomandibular in pacient submetid to ameloblastome

Os autores descrevem uma técnica para elaboraçäo de prótese maxilomandibular em paciente desdentada total, submetida a cirurgia de ameloblastoma na regiäo mentoniana esquerda, com necessidade de remoçäo de parte da mandíbula, após realizaçäo de implante do osso ilíaco. A elaboraçäo da prótese seguiu orientaçäo preconizada na Faculdade de Odontologia de Piracicaba, com ênfase à fase de moldagem funcional e ajuste oclusal, buscando maior estabilidade e retençäo da prótese sobre um tecido altamente comprometido pela ausência de rebordo alveolar

Reparación de protesis fijas plurales mediante aditamentos telescópicos / Repair of pleural fixed prosthesis using telescopic additions

La porcelana fundida sobre metal es la técnica restauradora más comúnmente aplicada en odontología. Su portencial de fracaso se debe en parte a las variables en la fabricación y su función. La finalidad del presente artículo es describir una reparación predecible para éstas restauraciones a través del manejo adecuado de superficies, el uso de un sobrecolado telescópico, y la aplicación de los principios de la odontología estética adhesiva

Repair of an aged, contaminated indirect composite resin with a direct, visible-light-cured composite resin.

This study investigated the interfacial shear bond strength of a contaminated, aged, heat- and pressure-processed, indirect composite resin (Concept) repaired with a direct, visible-light-cured composite resin (Heliomolar). Concept samples were aged by thermocycling and contaminated in tobacco juice. The bonding surfaces were prepared by sanding with 500-grit sandpaper or air abrading with 50-micron aluminum oxide. Prepared Concept surfaces received one or more of the following intermediary resin treatments before the addition of Heliomolar: Heliobond, Special Bond 2, All-Bond system, All-Bond bonding agent, or no bonding agent, and they were immediately thermocycled. Air abrasion produced significantly higher bond strengths than sanding for all intermediary resin surface treatments. The All-Bond-treated Concept surfaces showed the highest interfacial bond strengths within the air abraded and sanded groups. Visual and SEM examination of fractured repair surfaces indicated adhesive failure within all treatment groups.